DR. DIANA RENEE WALLACE (NPI# 1710993845) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710993845 |
| Entity Type | Individual |
| Full Name | DR. DIANA RENEE WALLACE |
| Credential | MD |
| Practice Address |
7900 Turin Road Building 4, Suite 2 Rome NY 13440-7423 |
| Practice Telephone | 3153387284 |
| Practice Fax Number | 3153387286 |
| Mailing Telephone | 3153387284 |
| Mailing Fax Number | 3153387286 |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2015-11-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207V00000X | Obstetrics & Gynecology | MD 2015-0031 | NM | Allopathic & Osteopathic Physicians |
| Y | 207V00000X | Obstetrics & Gynecology | 255422 | NY | Allopathic & Osteopathic Physicians |
| N | 207V00000X | Obstetrics & Gynecology | MD 433457 | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | GATEWAY-WMG | 1572573 | 01 |
| PA | AETNA | 92199182 | 01 |
| PA | AMERIHEALTH MERCY-WMG | 20076171 | 01 |
| MD | CAREFIRST MD BCBS | 932354 | 01 |
| PA | JOHNS HOPKINS | 212422 | 01 |
| PA | HIGHMARK BLUE SHIELD | 2039121 | 01 |
| PA | CAPITAL BLUE CROSS-WMG | 50077199 | 01 |
| PA | GEISINGER HEALTH PLAN | 118476 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669859849 | Diana Wallace | Occupational Therapist | 1207 N 33rd St, Renton, WA 98056-1943 | 2015-04-27 |
| 1457433146 | Diana Kay Wallace | Counselor | 518 S Jeffers St Ste 7, North Platte, NE 69101-5370 | 2006-10-20 |
| 1497837645 | Diana Lynn Wallace | Dietitian, Registered | 8086 S Yale Ave, Ste. 184, Tulsa, OK 74136-9003 | 2006-10-19 |
| 1336145432 | Diana Wallace | Social Worker | 1 Nunn Dr, University Center, Suite 440, Newport, KY 41099-0002 | 2005-06-23 |
| 1790027852 | Diana Tyson Wallace | Counselor | 3737 Lander Rd, Cleveland, OH 44124-5712 | 2013-03-26 |
| Street Address |
7900 TURIN ROAD BUILDING 4, SUITE 2 |
| City | ROME |
| State | NY |
| Zip Code | 13440-7423 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801409966 | Jamie Marcinkowski | Nurse Practitioner | 1617 N James Street, Suite 100, Rome, NY 13440 | 2020-08-28 |
| 1205452810 | Nichole Elizabeth Pollard | Optometrist | 1320 Floyd Ave, Suite 1, Rome, NY 13440 | 2020-06-19 |
| 1235750662 | Nicole Schrader | Social Worker | 7214 Bunal Blvd, Rome, NY 13440 | 2020-04-27 |
| 1457908212 | Darlene A. Sherman | Technician | 101 Glen Road S., Rome, NY 13440 | 2019-08-26 |
| 1841846847 | Delores A Smith | Technician | 7374 Davis Road, Rome, NY 13440 | 2019-08-15 |
| 1609342807 | Kent A Myers | Occupational Therapist | 200 West Dominic St, Rome, NY 13440 | 2018-10-16 |
| 1013376870 | Bonnie Flansburg | Physical Therapy Assistant | 101 W Liberty Street, Rome, NY 13440 | 2016-02-22 |
| 1760888689 | Ashley Elizabeth Bloomquist | Pharmacist | 808 West Chestnut Street, Rome, NY 13440 | 2014-11-05 |
| 1902231483 | Stephanie Ostalkiewicz | Licensed Practical Nurse | 701 Camp Street, Rome, NY 13440 | 2013-09-04 |
| 1992142251 | Tammy S. Guiliano | Registered Nurse | 401 Turin Street, The New York State School for The Deaf, Rome, NY 13440 | 2013-05-28 |
| Find all providers in zip 13440 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033403787 | Ijeoma Ibezue | Obstetrics & Gynecology | 1608 Martha Berry Neblvd, Rome, GA 30165-1622 | 2011-05-29 |
| 1134244189 | Luigi Donfrancesco | Obstetrics & Gynecology | 44 Lungotevere Mellini, Studio Pignanelli, Rome, RM 00193 | 2007-03-20 |
| 1568522829 | John Tollison Collins | Obstetrics & Gynecology | 316 W 10th St Ne, Rome, GA 30165-2639 | 2006-12-09 |
| 1417047457 | Nancy S Peek | Obstetrics & Gynecology | 8080 Turin Rd, Rome, NY 13440-1910 | 2006-10-13 |
| 1356444160 | Lauren Ann Giustra | Obstetrics & Gynecology | 107 East Chestnut Street, Rome, NY 13440 | 2006-09-07 |
| 1710080593 | Ankur Desai | Obstetrics & Gynecology | 107 East Chestnut St, Rome, NY 13440 | 2006-09-06 |
| 1710098942 | Leigh Saunders Barrell | Obstetrics & Gynecology | 1608 Martha Berry Blvd Ne, Rome, GA 30165-1622 | 2006-08-31 |
| 1821092669 | Marc Merrick Dean | Obstetrics & Gynecology | 330 Turner Mccall Blvd Sw, Rome, GA 30165-5630 | 2005-06-09 |
| 1205219813 | Courtney Nicole Pineau | Obstetrics & Gynecology | 7900 Turin Rd, Building 4, Suite 2, Rome, NY 13440 | 2015-06-30 |
| 1669863379 | Rome Medical Practice | Obstetrics & Gynecology | 7900 Turin Rd, Building 4, Suite 2, Rome, NY 13440-1900 | 2015-02-17 |
| Find all providers in ROME | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.